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• W4381194162 abstract "Objectives To investigate the effects of remimazolam on postoperative cognitive function, intraoperative hemodynamics and oxygenation in elderly patients undergoing lobectomy. Design A prospective, double-blind, randomized, controlled study. Setting A university hospital. Participants Eighty-four elderly patients with lung cancer who underwent lobectomy, aged ≥65 years. Interventions Patients were randomly divided into the remimazolam (Group R) and propofol (Group P) groups. Group R: remimazolam anesthesia induction and maintenance; Group P: propofol anesthesia induction and maintenance. Cognitive function was assessed with neuropsychological tests 1 day before surgery and 7 days after surgery. The Clock Drawing Test (CDT), Verbal Fluency Test (VFT), Digit Symbol Switching Test (DSST) and Auditory Verbal Learning Test-Huashan (AVLT-H) assessed visuospatial ability, language function, attention and memory, respectively. The systolic blood pressure (SBP), HR, mean arterial pressure (MAP) and cardiac index (CI) were recorded at 5 min before induction of anesthesia (T0), 2 min after sedation (T1), 5 min after intubation with two-lung ventilation (T2), 30 min after one-lung ventilation (OLV) (T3), 60 min after OLV (T4) and at the end of surgery (T5), and the incidences of hypotension and bradycardia were recorded. The arterial oxygen partial pressure (PaO2), oxygenation index (OI) and intrapulmonary shunt (Qs/Qt) were assessed at T0, T2, T3, T4 and T5. The levels of S-100β and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA) at T0, T5, 24 hours after surgery (T6) and on Day 7 after surgery (T7). Measurements and main results The VFT, DSST, immediate recall AVLT-H and short-delayed recall AVLT-H scores were significantly higher in the Group R than in the Group P on Day 7 after surgery (P < 0.05). The SBP and MAP at T2-T5 were significantly higher in the Group R than in the Group P, the incidence of hypotension was significantly lower in the Group R (9.5%) than in the Group P (35.74%) (P = 0.004), and remimazolam significantly reduced the dose of phenylephrine used (P < 0.05). The PaO2 and OI at T4 were significantly higher in the Group R than in the Group P, and Qs/Qt was significantly higher in the Group R than in the Group P. The levels of S-100β at T5 were significantly lower in the Group R than in the Group P (P<0.05). Conclusion The results show that remimazolam (vs propofol) may lessen the degree of short term postoperative cognitive dysfunction as measured by standard neuropsychological tests, better optimize intraoperative hemodynamics, and lead to improved oxygenation during OLV." @default.
• W4381194162 created "2023-06-20" @default.
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• W4381194162 date "2023-10-01" @default.
• W4381194162 modified "2023-09-24" @default.
• W4381194162 title "Propofol Versus Remimazolam on Cognitive Function, Hemodynamics, and Oxygenation During One-Lung Ventilation in Older Patients Undergoing Pulmonary Lobectomy: A Randomized Controlled Trial" @default.
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• W4381194162 doi "https://doi.org/10.1053/j.jvca.2023.06.027" @default.
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